How Can We Assess ‘Suicidality’ In First-Episode Psychosis? Use Of Columbia Suicide Severity Rating Scale

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Presentation First Author:

Vivek Phutane

Abstract:

Objective: The first five years after psychosis onset represent a high-risk period for suicide in schizophrenia. Detailed assessments of suicidality in first-episode psychosis (FEP) patients will permit more targeted and effective prevention. Method: A sample of 53 patients (mean age 23.3 years, SD 5.5) who were early in the course (DUP median 26 weeks with range 0-101 weeks) of a schizophrenia spectrum disorder were assessed for suicidal intent and behavior with the Columbia Suicide Severity Rating Scale (C-SSRS) over the first year of treatment. Results were correlated with routine clinical assessment and hospitalization rates. Results: At baseline, the clinical interview missed 25% (3 of 12) of patients classified by C-SSRS as having history of suicidal ideation (SI) and 14% (1 of 7) of patients having history of suicide attempt (SA). These rates were similar at 6-month and 1-year follow-up. C-SSRS additionally differentiated suicidal ideation from planning, and stratified suicidal attempt by lethality. At 6-month and 1-year follow-up, there was reduction in overall suicidality. Prior hospitalization at baseline was correlated (Spearman’s correlation) with history of suicidal ideation (r = 0.55; p